医用胶黏合技术在无血管吻合条件的指尖离断中的应用研究

Application of Medical Adhesive in the Fingertip Detachment without Vascular Anastomosis Condition

目的探讨医用胶黏合技术在无血管吻合条件的指尖离断治疗中的应用效果。方法自2017年1月到2019年3月,选择60例指尖离断且无血管吻合条件的患者作为研究对象,随机分为医用胶黏合组、原位回植组和近端皮瓣移植组,每组各20例,分别给予相应治疗。对比三组患者的手术时间、断端存活率、疼痛评分,并对患者进行6个月随访,观察患者手指两点辨别觉,通过断指再植功能评定试用标准进行评分。结果医用胶黏合组手术时间和疼痛评分均优于其他两组(P<0.001),三组在离断组织存活率方面无明显统计学差异(P>0.05)。随访结果显示,医用胶黏合组两点辨别觉优于近端皮瓣移植组(P<0.05);在功能评定方面,医用黏合胶组在总体评分、感觉恢复评分及外观评估中评分更高(P<0.05)。结论医用胶黏合技术可有效应用于无血管吻合条件的指尖离断的临床治疗中,可减轻患者痛苦、改善手指外观、减少感觉异常,值得临床推广应用。

Objective To explore the application efficacy of medical adhesive in the fingertip detachment without vascular anastomosis condition.Methods From January 2017 to March 2019,60 patients with severed fingertip and no vascular anastomosis conditions were selected and randomly divided into medical adhesive group,in-situ replantation group and proximal flap transplantation group,with 20 patients in each group receiving corresponding treatment.The operation time,survival rate of fingertip and VAS score were compared among the three groups.All the patients were followed up for 6 months to compare the two point discrimination and score of function evaluation standard for hand replantation surgery among the three groups.Results The operation time and VAS score of the medical adhesive group were better than those of the in-situ replantation group and proximal flap transplantation group(P<0.001),but fingertip survival rates were similar in all three groups.Long-term follow-up result showed that the two point discrimination of the medical adhesive group was better than that of the proximal flap transplantation group(P<0.05).In terms of functional evaluation,the medical adhesive group scored higher in total score,sensory recovery and appearance evaluation,with more significant advantages(P<0.05).Conclusion Medical adhesive can be effectively applied in the clinical treatment for the fingertip detachment without vascular anastomosis condition.It can reduce the pain of patients,improve the appearance of fingers,reduce paresthesia,and is worthy of clinical promotion and application.